Welcome to Part VI of "Good Looking Loser's Guide to Hair Loss Prevention".
In the previous section, "Your Hair vs. Anabolic Steroids (Part V)" which was published on GoodLookingLoser.com due to the nature of the topic, we discussed how you might be able to use anabolic steroids and maintain a good head of hair if you are prone to Male Pattern Baldness.
We are going to talk about Hair Transplants in this section.
Like all prior sections, this portion and the entire "Hair Loss Prevention Guide" is subject to our Medical Disclaimer.
It is not medical advice nor the replacement for advice from a qualified physician.
I am not a hair restoration doctor or a physician. These are simply my opinions and you should confirm them with a hair restoration surgeon.
This is for educational purposes ONLY and should only be followed if approved by a physician.
How Surgical Hair Restoration Works
I'm going to keep this brief since you might already know and there's plenty of other websites that can explain the procedure to you.
You have hair on the BACK and SIDES of your head that is forever immune to DHT from Male Pattern Baldness and will never miniaturize.
This is called the "donor area".
You have hair on your scalp and hair line that has become thinner or non-existent.
A hair transplant takes hair from the BACK and SIDES of your head (donor area) that is not subject to thinning and moves it to the balding areas that need coverage.
These hairs are permanent and behave just as they would if they were in their original location.
They grow, they shed and they grow back without ever getting thinner.
There's two main types of hair restoration procedures -
Regardless of which procedure you get, it takes about 7 or 8 months for the transplanted hairs to grow. By 12 or 14 months, they have pretty much reached their potential.
While the transplanted hairs will not thin (or "fall out") it is important to stabilize your hair cycle so that your native hair doesn't become thinner and thinner.
My Hair Transplant History and Results
I have had 2 hair small-moderate restoration procedures.
One harvested 2134 grafts (2007) and one harvested 1639 grafts (2009).
Both procedures placed hairs on my hair line and in the frontal zones.
I have had no work done on the crown.
I probably would not have needed either procedure had I not taken significant amounts of anabolic steroids for considerable amounts of time in my 20's.
I don't regret it though.
These transplants (and the concealers) give me the appearance of a ~full head of hair today.
What I would have done differently, however, was to make certain I was at least following the "Hair Loss on a Budget" stack.
Hair Transplant Before and After Pictures
My pictures from my first procedure in 2007 don't really show a significant difference because I had a near full hair line to begin with.
Here are more dramatic pictures that capture what I looked like before the second transplant (2009) right up until last week (2014).
(as bad as it was in 2009, the concealer products that I recommend camouflaged absolutely all of it)
What to Expect From a Hair Transplant
So long as you go to a quality hair restoration surgeon - you can expect to significantly fill in the zones that are thinning.
With concealers - you can achieve ~100% in these areas.
You can also get 65-75% coverage in the 'rebuilding' zones that no longer have hair.
With concealers - you can achieve 95-100% coverage in these areas.
It's important to know that - YOU WILL NOT GET A FULL HEAD OF HAIR after just a single procedure unless you have only lost a very small amount of hair.
It would take about ~40,000 or 50,000 grafts to restore FULL COVERAGE to a bald head and you are limited to about 17,500 to 40,000 grafts (assuming you tap into your scalp donor hair, beard hair, nape hair, body hair, etc).
(this is just an estimate, this will vary tremendously and the 'quality' of the donor hair and the skill of your surgeon is very important)
Achieving a TOTALLY FULL HEAD OF HAIR doesn't need to be your only goal because you can use the concealers to fill in the rest.
You need to make sure that you have enough hair (whether transplanted or native) spread out just enough to make the concealers work.
We discuss this below in "Good Looking Loser's Platform Approach".
Prices on these surgeries vary.
It will be up to $10,000 for 1500-2000 FUT grafts from a quality surgeon.
(my doctor is less expensive)
Megasessions of upwards of 4000 FUT grafts will be closer to $20,000.
FUE prices vary and I haven't gotten that procedure done.
Body hair transplantation (BHT) prices vary as well.
Both are more expensive than FUT.
How to Pick a Hair Restoration Surgeon
This is important, so please listen.
You shouldn't consider a hair restoration procedure until you have Finasteride (and Minoxidil, Ketoconazole) for at least an entire year and ~stabilized your hair loss situation.
I HIGHLY RECOMMEND only considering doctors that ONLY do hair transplantation surgeries and aren't a "jack of all trades" and offer several cosmetic procedures.
I HIGHLY RECOMMEND knowing EXACTLY WHO WILL BE DOING YOUR SURGERY and meeting your doctor in-person (or at least multiple conversations on the phone) to discuss your goals and hair loss history.
A lot of the major companies such as "B0z-Lee" and "Medical Hair Restoration" (defunct) do not even tell you who will be cutting your head open and transplanting valuable donor hair that you are paying thousands for until literally minutes before your surgery.
Do not go to one of these mainstream transplant factories.
While some very good doctors work for them, any doctor with elite skill will have his own practice, protocol and staff.
You need to know the name of your doctor so you can do research on him.
You need to do a search for the doctor's last name on every one of the 4 major hair loss communities -
After that, start a thread at each community to see what people say.
Note that - not all of these communities are totally "independent" or "unbias".
Some communities censor negative feedback and their "approved/recommended" physicians simply pay for a membership.
Do not consider positive or negative feedback from the moderators to be gospel.
(there are some honest moderators however)
See what the regular members that actually went to the doctor and chronicled their entire experience say.
Your best bet is to run a search in ALL the communities and see which feedback is consistent and which is not.
After that, do some additional searching on Google and Bing -
Consider these search keywords -
After that, you can consider NON-PROFESSIONAL before and after pictures you see on the forums/blogs and loosely consider the professional (edited) before and after pictures that you see on the doctor's website.
Professional before and after pictures are nice but not always evidence of the typical work that the surgeon does.
They are mainly for marketing.
If this seems like a lot of work or you want to absolutely make certain that you get a world class hair restoration surgeon, just go see my doctor -
Dr. Gabel is a terrific surgeon and will maximize the density that each graft achieves.
He is actually VERY INEXPENSIVE as compared to doctors that do the same quality of work.
I travelled to see him.
If you visit him in Hillsboro, OR. plan for a long procedure and bring some protein bars - even though he will buy you lunch.
Transplanting just over 1500 grafts took us nearly 15 hours, while my first procedure (over 2000 grafts) took just 3.5 hours.
He gives an incredible attention to detail, it will be a LONG DAY but it's worth it in the long run.
I wish I had gone to him for my first procedure, even though I didn't receive bad work in 2007 (won't be naming doctor).
Not that it matters to everyone but: I also think Dr. Gabel is honest and a good guy.
I trust him (and his staff) enough to recommend him to you.
I receive no compensation for my recommendation whatsoever.
He will be doing ANY and ALL future work on my hair.
The world of cosmetic surgery is filled with near-scam artists parading around as doctors.
You are required to sign a waiver saying that you can't sue (or publish negative results on the Internet, in some cases) if you aren't happy. This is standard but some doctors seize this opportunity to screw (and sometimes disfigure) desperate people.
Do your homework so you don't become a victim.
If you do use Dr. Gabel - tell him "Chris from Good Looking Loser" sent you.
They will make extra sure that you are 110% happy.
Please don't write in and expect me to know if [insert Doctor's name] is good and if you should go to him.
Unfortunately, I can't possibly know all the doctors.
My recommendation is to fly to Portland (Hillsboro is a suburb) to see Dr. Gabel and get it done right for a good price.
(Portland is a decent city - stay in a nice hotel, see the Rose Garden, Zoo, Pioneer Place (mall), Farmer's Market, Voodoo Donuts, etc.)
If you can't do that - find a surgeon via the methods I suggest above.
(hint: some doctors will give you a discount if you promise to do a hair loss blog for them - do not base this on your final decision however)
My "Platform Approach" For a Full Head of Hair
I'm not a doctor but this is my long-term approach to my hair.
It is super important that you stabilize your hair cycle (as best you can) before you get a bunch of hair transplants.
What I am shooting for is what I call the "Platform Approach". I thought of the term myself.
Basically, it works like this -
If you want [the appearance] of a full head of hair that will last forever, I suggest focusing on your hair line and frontal zones nearly completely restored, as I have.
In the future, you can fill in the crown area and mid-scalp zones as best you can/can afford. You can use beard hair and body hair for these locations if you absolutely have to. Micropigmentation (discussed below) can also assist these areas.
This is why -
The concealers (largely, Toppik) work amazingly well for the crown, mid-scalp and non-hair line frontal zones.
But not as well on the hair line.
Even if your crown/mid-scalp only achieves average density, you still will be able to fill these zones in with the concealers.
The top of my head has only had 30-35% coverage for the past 7 or 8 years and I can fill the entire thing in.
The hair line, however, frames your face and needs to have significant density to look good.
The idea is to build a decent "platform" on your scalp for the hair fibers to attach to.
This is how I'm approaching things.
I'm not trying to regain a full head of hair.
Just a good hair line and enough hair elsewhere to throw hair fibers on.
So far it's worked great and Dr. Gabel highly approves.
Full Head of Hair or Bust
Even if you are in the advanced Norwood stages, you can have [the appearance] of a full hair of head if you ABSOLUTELY want it.
It depends on how much hair you want/need but body hair, beard hair, nape (neck) hair and micropigmentation is always an option if you absolutely want a ~FULL HEAD of hair.
Just make sure you have a doctor that knows how to extract and plant these grafts. Many don't and are literally learning on the fly.
(for experimental purposes, Dr. Gabel planted 96 beard hairs in my mid-scalp - they worked great and grow almost as long as scalp hair, their texture is different but only I know that)
Micropigmentation - Hair Tattoo
There's a somewhat new 'restoration' procedure now available to common folk that offers even the most advanced cases of Androgenic Alopecia an appearance of a full head of hair.
It's called "Micropigmentation".
Basically, it's done by getting tens of thousands of small (micro small) tattoos all over the scalp.
The micropigments look nearly identical to full hairs that have received a buzz cut.
Results appear right away -
Micropigmention can also help camouflage a FUT scar.
(see picture below)
In April of this year, I flew to Chicago to have Dr. Gabel make my scar disappear and throw a bunch of micropigments on the frontal zones of my hair.
Here's some pictures -
Since I have decent hair coverage, you can't really see a significant difference from a distance.
I now need less hair fibers however and my scar is almost undetectable from up close.
If I don't apply any hair fibers, the only area that appears thin is the crown area.
I recommend Micropigmentation.
It depends on your current hair loss situation and your ultimate goals however.
Micropigmentation looks particularly awesome on black guys (but really anyone who looks good with super short hair).
By this point, I've almost taught you everything I know (and experienced) about Male Pattern Baldness and Hair Restoration.
Whenever I hear -
"Chris gets girls because he has a full head of hair..."
I want to laugh.
The truth is - I don't have a "full head" of hair.
I haven't since 2003.
But I'm resourceful.
Just like you.
Hair loss, like so many conditions/circumstances can be "gamed" if you have the correct information and the right experts to help you.
You just have to put forth the effort.
There's definitely a psychological element that should be addressed to getting cosmetic surgery of any kind -
Will it be a gateway to more surgery?
Will you become more obsessed with your appearance?
Will you be happier?
In my case (and just about everyone else) that has followed through with a quality hair restoration procedure(s) - it was a fantastic decision and I regret ABSOLUTELY NOTHING.
The time to be beautiful is in your 20's and 30's.
Don't let something stupid like hair loss get in your way.
Don't listen to the conservative sideliners that tell you that you should "wait" until you are 45 years old.
(provided that you don't have a medical problem causing your hair loss, stabilize your hair loss as best you can and can benefit from a procedure)
Worst case scenario -
You can get more work done.
It's better than being self-conscious about it all day.
You can pull the plug at any time, get the Micropigmentation to conceal your scar and shave your head.
But that's just my opinion.
Good Looking Loser's Guide to Hair Loss Prevention continues here -
For questions on our Hair Loss Prevention Guide -